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Our Specialized Evaluation Process

Although a yearly mammogram starting at age 40 is recommended for most people, individuals with an increased risk for breast cancer may want to consider screening earlier. It’s important to note that mammography screening can only detect — not prevent – breast cancer.

Understanding your individual risk of breast cancer, and the specific things that could help to minimize that risk, is the best way to manage breast health. Stamford Health’s High-Risk Program can help evaluate your risk and create an individually tailored care plan to manage that risk.

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Breast Center


Breast Cancer Risk Factors

The following inherited factors could increase the risk of developing breast cancer. If you have any of the below, please discuss with your doctor or call our breast specialists at 203.276.5905.


FAMILY DIAGNOSED WITH BREAST OR OVARIAN CANCER

The risk for breast cancer is higher if a first-degree relative (mother or sister) have had breast or ovarian cancer. Certain other cancer diagnoses in multiple extended family members could also indicate a higher risk.

ADVANCED AGE

The risk for breast cancer increases with age; most people are diagnosed after 50.

GENETIC MUTATIONS

Those who have inherited changes (mutations) to certain genes, such as BRCA1 and BRCA2, are at increased risk of breast and ovarian cancer.

DENSE BREASTS

Although there is no clear reason why, people with dense breast tissue are more likely to have breast cancer. Also, dense breasts make it harder for tumors to be detected on mammograms, meaning smaller tumors could be missed. Breast ultrasound or MRI may be suggested if you have dense breasts.

PRIOR BREAST OR OVARIAN CANCER DIAGNOSIS

If you already had breast or ovarian cancer, you are more likely to get it in the future.

EARLY PERIOD OR LATE MENOPAUSE

Starting menstrual periods before the age of 12 or beginning menopause after 55 mean an increased exposure to hormones, which can raise the risk of breast cancer.

FAMILY DIAGNOSED WITH BREAST OR OVARIAN CANCER

The risk for breast cancer is higher if a first-degree relative (mother or sister) have had breast or ovarian cancer. Certain other cancer diagnoses in multiple extended family members could also indicate a higher risk.

ADVANCED AGE

The risk for breast cancer increases with age; most people are diagnosed after 50.

GENETIC MUTATIONS

Those who have inherited changes (mutations) to certain genes, such as BRCA1 and BRCA2, are at increased risk of breast and ovarian cancer.

DENSE BREASTS

Although there is no clear reason why, people with dense breast tissue are more likely to have breast cancer. Also, dense breasts make it harder for tumors to be detected on mammograms, meaning smaller tumors could be missed. Breast ultrasound or MRI may be suggested if you have dense breasts.

PRIOR BREAST OR OVARIAN CANCER DIAGNOSIS

If you already had breast or ovarian cancer, you are more likely to get it in the future.

EARLY PERIOD OR LATE MENOPAUSE

Starting menstrual periods before the age of 12 or beginning menopause after 55 mean an increased exposure to hormones, which can raise the risk of breast cancer.

What to Expect During an Initial Evaluation

Arlene Butler, a nurse practitioner who specializes in high-risk patients, will determine your risk after a detailed family and medical history intake and a thorough breast exam. If you need additional care, our breast specialist, who has extensive experience helping women at high risk for breast cancer, will create a personalized care plan. Recommendations may include any of the following:

  • Advice on prevention and risk-reducing lifestyle changes.
  • Additional imaging tests, such as a breast magnetic resonance imaging (or MRI, a highly sensitive test that can detect problems early) in addition to a mammogram.
  • Referral to specialists, such as a medical oncologist to discuss medication that may lower your breast cancer risk, or to a genetic counselor, who can help you understand health conditions that run in your family.
  • Regular follow-up exams to monitor and oversee your breast health.

Arlene E Butler
Arlene E Butler, APRN
Breast Surgery

(203) 276-4255

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Our Nurse Navigator Program




Whether you have been diagnosed with breast cancer or need additional imaging, our nurse navigators are dedicated to helping you navigate the health care system. They work as a liaison between doctors, patients, and family members or care partners to answer questions about appointments, test results, and more. More importantly, nurse navigators are there to provide support throughout your health journey.

More Resources For High-Risk Candidates

CANCER GENETICS PROGRAM

Our certified genetic counseling team can provide an individualized assessment of personal cancer risk and can evaluate what role genetic factors may contribute to the risk of developing breast cancer. Genetic testing can provide concrete information about cancer susceptibility genes to help you understand your lifetime breast and ovarian cancer risks.

LIFESTYLE MODIFICATION

Our breast navigators will work with you to discuss breast cancer prevention and risk-reducing lifestyle changes. In addition, our Sarner Health and Fitness Institute offers fitness classes, personalized training, and more. You can choose from an array of specialized programming, including water aerobics and yoga.

SPECIALIZED SURVEILLANCE

If you are at high risk for breast cancer, you may benefit from more frequent screenings and the use of specialized technologies that enhance imaging in specific ways. Surveillance for high-risk patients involves additional breast screenings using digital mammography with computer-assisted detection in addition to breast ultrasound and high-resolution MRI.

RISK-REDUCING MEDICATION

Certain medications, like Tamoxifen, can be taken preventively to reduce the likelihood that breast cancer will develop. Medical oncologists at the Bennett Cancer Center will work with you to find the best therapy to help reduce your risk.

CANCER GENETICS PROGRAM

Our certified genetic counseling team can provide an individualized assessment of personal cancer risk and can evaluate what role genetic factors may contribute to the risk of developing breast cancer. Genetic testing can provide concrete information about cancer susceptibility genes to help you understand your lifetime breast and ovarian cancer risks.

LIFESTYLE MODIFICATION

Our breast navigators will work with you to discuss breast cancer prevention and risk-reducing lifestyle changes. In addition, our Sarner Health and Fitness Institute offers fitness classes, personalized training, and more. You can choose from an array of specialized programming, including water aerobics and yoga.

SPECIALIZED SURVEILLANCE

If you are at high risk for breast cancer, you may benefit from more frequent screenings and the use of specialized technologies that enhance imaging in specific ways. Surveillance for high-risk patients involves additional breast screenings using digital mammography with computer-assisted detection in addition to breast ultrasound and high-resolution MRI.

RISK-REDUCING MEDICATION

Certain medications, like Tamoxifen, can be taken preventively to reduce the likelihood that breast cancer will develop. Medical oncologists at the Bennett Cancer Center will work with you to find the best therapy to help reduce your risk.


High-Risk Breast Cancer FAQs

  • What is the high-risk breast program, and who should consider it?
    The high-risk program at Stamford Health is a specialized program designed for individuals who are at an increased risk of developing breast cancer. High-risk individuals may have a family history of breast cancer, genetic mutations, or other risk factors. This program provides a personalized risk assessment, advanced screening options, and comprehensive care for those who may benefit from increased vigilance in breast cancer prevention and early detection.
  • How can you assess your own risk for breast cancer before seeking consultation?

    Before seeking professional consultation, you can take proactive steps to assess your breast cancer risk. Start with regular self-exams to become familiar with your breast tissue and detect any changes. While self-exams aren't definitive, they help identify potential issues. Look for lumps, size or shape changes, skin dimpling, nipple changes, or discomfort. Keep a record and consult a specialist if you notice persistent changes.

    In addition to self-exams, consider family history, personal breast cancer history, and genetics. A health care provider specializing in breast health can conduct a comprehensive risk assessment, evaluating your unique risk factors, and discussing preventive measures, including advanced screenings or genetic testing if needed.

  • How can you get a referral to the high-risk breast program at Stamford Health?

    You can obtain a referral to the high-risk breast program by:

    • Contacting your primary care physician or OB-GYN and discussing your interest in the program.
    • Directly contacting our office to request a consultation. For help guiding next steps, contact one of our breast navigators at 203.276.4910. Or, if you prefer, contact our navigator, Carolina Builes at 203.276.5905 to schedule an appointment with the breast specialist.
    • If you are referred by another specialist or health care provider, they can facilitate the referral process.

    Our team is dedicated to helping you navigate the referral process and ensuring that you receive the specialized care you need.

  • Are there lifestyle modifications that can help reduce breast cancer risk for high-risk individuals?

    Yes, certain lifestyle modifications can help reduce the risk of developing breast cancer in high-risk individuals. These may include:

    • Maintaining a healthy weight through diet and exercise.
    • Reducing alcohol consumption.
    • Engaging in regular physical activity.
    • Considering risk-reducing medications if recommended by your health care provider.
    • Staying vigilant with recommended screenings and risk-reduction strategies.

    The high-risk breast program at Stamford Health can provide guidance and support to help you make informed choices to reduce your risk. If you’d like guided support with making lifestyle changes, our Sarner Health and Fitness Institute also offers medically supervised fitness and lifestyle changes.

  • What support groups or counseling options are available for women in the high-risk program?
    Stamford Health recognizes the importance of emotional support for individuals in the high-risk breast program. We offer access to support groups, counseling services, and resources to help patients cope with the emotional and psychological aspects of their journey. Additionally, genetic counseling is available for those with hereditary risk factors, providing information and support regarding genetic testing and its implications. Our team is dedicated to ensuring that individuals in the program have a well-rounded support system to address their unique needs and concerns.

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